THE EFFECTS OF OCTREOTIDE ON HEALING OF SMALL-BOWEL ANASTOMOSIS

Octreotide (OCT) is a somatostatin analog used for its inhibitory acti on on multiple GI functions. Although octreotide has numerous clinical benefits, it has also been shown to inhibit postresectional hyperplas ia of small bowel and hepatic regeneration. Because octreotide inhibit s both trophic and anabolic hormones, we hypothesize that the use of o ctreotide may be detrimental in patients with a recent bowel anastomos is. To test this hypothesis, 60 male rats were randomized to four equa l groups following small bowel anastomosis. Group I = control; Group I I = 10 mg/day of hydrocortisone succinate; Group III = 2.5 mu g/kg/day octreotide (equivalent of a clinical dose); Group IV = 25 mu g/kg/day octreotide. Hydrocortisone was used as a negative control because it is known to have inhibitory effects on small bowel anastomotic healing . On postoperative Day 7, bursting pressures were measured. Serum T-ki ninogen levels, as a marker for systemic inflammation, and hydroxyprol ine content from the anastomotic segments were obtained. These results indicate that in the rat small bowel model, octreotide did not have a ny deleterious effect on anastomotic strength, systemic inflammation, and collagen content, even at high doses. Hydrocortisone, as expected, showed significant detrimental effects on bursting strength, as well as decreasing systemic inflammation. These findings have significant c linical implications, as octreotide could be used without jeopardizing the intestinal anastomosis.